Whats your feeling?

Nurses General Nursing

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What are your feelings towards perinatal substance abuse?. Share your experiences, backgrounds, comfort in working with this problem in nursing.

I too work with drug addicted infants going through withdrawal,infants with fetal alcohol syndrome, etc, and yes it does make me very angry. I have 3 very healthy kids, and I take pride in the fact that I gave them a good start by providing them with a healthy uterine environment. However, I don't know exactly what the answer would be in order to help these families and children. We know that jail time does little to break a person of an addiction ( what better place to get drugs but in jail). Other punitive stances do little to help as well. Judgemental attitudes also do not help. I know that many of these women were abused themselves , are poor , frequently in abusive relationships, and all round horrible circumstances. Some of the Moms we see in our unit themselves have fetal alcohol syndrome. Are they to blame, maybe in some instances, maybe partially, but not all of the time. Its easy for me to say don't take drugs when your pregnant, get prenatal care, eat well etc,etc,, when I enjoy a middle class existence, have acess to universal health care (I live in Canada), and have a wonderful husband, family, and friends that support me. This is often not the case for these women. I do agree that a method of birth control should be ulitized until these women can (or if and when) get their lives together. I do not live in a dream world, nor do I agree with what these women and men do to their children. I do believe that these women DO NOT want to do this to themselves or their children. And every once in awhile we get a sucess story that, helps me reflect, think and again reach out to try and help. Its too bad that most days I feel like I'm banging my head against the wall. It is an area that could use more research, funding etc, to try and break the cycle.

Suzy K, KDAY

What a wonderful world that would be! Can I have your fantasy too? Worked L&D in a charity hospital for 12 years. One summer we had 2 G21, yes, Gravity 21!! Neither one would consent to tubals. Why? They both said "I might want to have another one" can you believe it? And neither one had ever worked a day in her life!!! Yes, I want that fantasy too!!!

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Sheryl www.CrosswordsForNurses.com

[This message has been edited by puzzler (edited April 11, 2001).]

Specializes in LDRP; Education.

Oh.....my....god.

A gravida 21???????????????????????

Kday your story reminds me of a patient I had - who PROMed at her baby shower at 21 weeks - baby didn't survive.

That same week, a 19 y/o drug user, didn't realize she was pregnant (or so she said) although she was term and measured at 28 weeks - delivered her baby in the toilet at home - thick, thick, particulate meconium. It was so bad the cord and placenta were stained. Baby survived - and she kept it.

It's things like this that suck.

I also am familiar with the T-19 30 day wait period for tubals. It's ridiculous. I'm sorry but they should be mandatory.

Specializes in Everything except surgery.

I'm appalled by the majority of the posts I have read on here! First, why should women be sterilized because they make uneducated decisions? Why not educated, and do follow ups to show them a way out, not condemnation! Many of them see no way out, but to have a child, get welfare to escape abusive situations at home, that have become unbearable. Would you sterilize/or give these women on their first mistake? Their second? Have you read the literature on Depo?? I wouldn't take it!

Do you feel, because people are in need of help, that they should lose their civil right?? I have been working a lonnnng time now, and I would rather pay for a woman to have her child, and have supportive services to help her get an education, a skill, a job, that will allow her to gain her independence, rather than taking her rights away!

Yes, I have worked L&D, and the NICU in four different hospitals. Including a county hospital, where the unmarried was the norm, not the exception! I have never advocated sterilization as the means to an end! I have seen just as many supposedly "nice"(those who have the means, and the education, and not teenagers either) who still smoke, or drink, or do "recreational drugs, while pregnant! There's also women married to sorry men, who they know run around on them. But they have sex with these "husbands", who give them STDs while pregnant, because they're too afraid to ask them to wear condoms, protecting their unborn children, and themselves!

One case in point. Restaurant owners, having twins, woman doesn't even tell OB, that she has a discharge for weeks, and she is 38weeks...finds out she has The Big S! Why not tell OB? She was embrassed to have anyone know her own husband gave it to her!!

This is an educated business woman, who allowed her insecurities to stop her from seeking appropriate care! Should she have been allowed to conceive? Should the women, AND men, who have children, and abuse them because they were abused, be sterilized, or given depo also???

Those who are on welfare, are many times women who are left by husbands, who won't pay child support, and who thought they didn't need an education, because they were married. Many of these women are suffering from abuse, depression, poor coping skills, feeling of inadequacey, and helplessness! Many of the women on welfare feel that the only thing they can do, is have children, as their only sense of accomplishment. Yes, they are totally out of touch with reality, but these are the symptons, of abusive histories, that may have started in childhood. Do you want to take away the children, and sterilize these woman who make the mistake of getting married, having a bunch of kids, and getting a divorce, and finding she needs help from social services?

Maybe we need to go after the fathers, who have to be dragged back, and forth through the courts, in order for their children to be supported! Maybe we should threaten them with sterilization, not the women they take advantage of. No tadpoles, no babies!! But that wouldn't solve anything either, because most of these same men, also need education, and supportive services to help them become the men they should be. Many of these men, have seen their own fathers being abusive to women, non supported, or just not there at all!

Yes, it takes some people many times to go through drug treatment to get clean. It's not an easy process. But a drug treatment program is a lot cheaper, than sending them to prison, where they only get more drugs, come out, and continue to sell, rob, and kill! It also takes just as much time to get clean from alcohol, as it does drugs, and we accept that! We call it a disease, so why isn't addiction to drugs a disease? I met a counselor who it took him 13times, to get through a program, and get clean...but he did! Now he is helping others!

What are you doing to help educate young women, that they can have a better life, and not the ones, their parent(s) showed them? Are you a big sister/big brother? Do you volunteer your time to go to schools to talk plainly to young people about what you see in your jobs? Do you tell them they can succeed, even in the face of severe adversity?

Young people never believe anything can happen to them. These young women have no real idea of what their doing to their bodies, or their unborn. If they did, then something must be mentally wrong, and they need help to make appropriate decisions, not quick, assuming judgements!

I think too long, we have thrown bandaids on many of our social ills in this country, and just like nursing needs some real lasting solutions....so do these problems also!

My mother worked social services, and child protection for over 20yrs. My mother showed me, that I couldn't make snap judgements about things I had never experienced!

Yes, I was divorced, and didn't go get on welfare! But I had a support system when I got divorced, and two great parents, who provided a loving, caring, strong foundation. I have a 22yr old daughter with no children, who is waiting to get serious until she finishes school. She also has had a great support system, and became a fantastic, non drinking, non smoking, non drug using, totally committed Christian Woman, who volunteers at nursing homes! But what would have happened to her, if she hadn't come from such a great background with a supportive, and loving family?

I always think that, but for the Grace of God, there go I! I have taken many women into my home, who had no support systems!! Many people who never thought they would be homeless, are now! Many people who thought they would never be divorced, are now! Many women who thought they would never be in an abusive situation...are now! Many who thought they wouldn't have to ask for assistance...but they did!! Many who thought they would never end up on drugs...had careers, such as attorneys, nurses, doctors, fireman, policeman...politicans..but they are now!!!!

We have many problems, that need more than just contempt thrown at them! We need more caring people who are willing to do more than just talk about quick fixs, that will do nothing to put an end to the mentality, that supports the continuation of the breeding grounds that create these problems.

We must provide equal education for all! We must seek out those in need, and offer more than just lip service to making a difference. We must help the widow, and the family who has been abandoned, by showing them, that someone cares for them! Abused young women, that they don't need to have a child, so they can feel loved by someone! That even though they see life treated cheaply, they can rise above their situations, and be better than their surroundings! They don't have to follow the unending cycle, that they see unfolding around them daily.

There are many hurting people in the world, and suffering, depression, abuse, feelings of worthlessness, and hopelessness, raises it's ugly head in many forms.

Handing out Depo, doesn't do anything to stop the cycle, and I feel that taking children from mothers, is also not the solution!

Where are we going to house these children? There are no foster homes available now! Aren't we still paying for these children until their of legal age?? How much do would it cost?? Wouldn't helping the mother be able to take care of her own children be the best solution? I would rather help her become a stable parent, than to see a child be run through the system, only to end up in the same cycle also!!!!

This is the job my mother was doing until the day she died!! A social worker, who taught her clients, how to make food stamps last, how to apply for jobs, how to dress for an interview, how to balance a budget, how to care for thier children, and their homes. She was a foster mother, an active community volunteer, helped start the first community center in our neighborhood, and our house was the place all the kids came to! My mother took her clients out on her own time, to find apartments, get groceries, ..well I could go on, and on.

We can all make a difference in the lives of our young, who have had no real role models they can look up to. Even these women want a better life for themselves, and their children, but have no clue as to how to go about it. Are you willing to make a difference in the life of a child in need, that extends beyond the your own comfortable existance??? I would hope so!

Brownie

Hello Brownie,

My thoughts exactly, only you said it better than i could have. smile.gif

Everyone comes from all walks of life, not everyone is as fortunate as some. We cant make a difference if we dont try!! Yes this world of sorrows are to great to cure, but day by day we can pull together to make a difference.

You were very refreshing this morning after a long nights work.

I have a story for you. Last night at work i had a 14 year old female with c/o abd. pain x 3 weeks, so her sorry ass mother decides to finally bring her to the er. She had a raging UTI and oh ya she was also very, very , PREGNANT!!!!Then her sorry ass father decides hes going to show up and he precedes to tell me that his daughter lost there bet. I said excuse me , he says ya i bet her $100.00 that she would get pregnant within 1 month, and she said she wouldnt!!!Gee i dont know but you think maybe its because she is living with a 25 year old, having sex and unprotected sex at that. lets not forget this child is only 14!!! The doc had the parents leave the room and when he told her that she was pregnant she just started crying and said she had to get out of the house, because she just couldnt stand to live with them any more and take care of there other kids with no food to feed them and as you can immagine this story got worse.. But this is a good example OF NO WAY OUT AND NO WHERE TO TURN.....my heart cried out for her and no she didnt go back home or to the boyfriend. Lets all pitch in and do our part!!!! thanks

Hi Brownms, just for the record, I am not for sterilization, only a form of birth control(not nessarily depo) until these women can get the help they need. I agree with a lot of what you say.In my original posting, I was trying to balance my feelings with the the needs of these families, and also acknowledging that sometimes you need to VENT. We need to do this, because working with these families and sick babies is very painful for us. We are going to explode if we don't have this opportunity. I think you are right about education, and long term solutions. However governments never seem to support long term programs as the results of these programs never reach fruition while they are in office. I try very hard to be non-judgemental, when working with these families, as I have said before judgemental attitudes do little to help. But again, I also think that we need a forum such as this to vent our anger.We need to acknowledge this anger and then perhaps we can start to channel it away from the idividual, to the SITUATION. Then maybe we as perinatal nurse could start to lobby govt for more programs for education etc. Like I said before some days are very frustrating. But I also do not live the life these women often do. THANKS for the input!! Jan

Specializes in LDRP; Education.

Hi Brownie-

Ok, ok, ok. I hear you.

But the problem that I see is these women, or girls some of them, are repeat offenders. We offer them what we can - WIC assistance, car seat rentals, referrals up the ying-yang. These things are all paid for by our taxes. We try and try to educate these women, but in 10 months, they are back again, pregnant, drinking, doing drugs, not complying with thier welfare conditions (in Wisconsin, we finally implemented a mandate that now you don't automatically get more welfare with more children. Now, you have to work to get your aid. Our government will also GIVE you a job)

But these women don't show up for work, all their other 9 children are in foster care. I see it as a disgrace.

I am torn because I see having children as someone's right. But at the same time, too many people have children simply out of irresponsibility. They don't think of children as people that need love, a home, two parents if possible, food, shelter and guidance. These are little lives, not toys that just "give" you love! How selfish to have children just so you aren't "lonely" or because you need someone to love you. I view having children as the most important decision anyone can make.

My mom works with someone who is 24 years old and has 2 children already. She is unmarried, but living with the father of the children. My mom asked her when she plans on getting married. Her response was, "well we're not sure if we are ready for that kind of committment yet." Committment??? Marriage?? And having children is not as serious a committment??? It is this mentality that disturbs me.

I just am so bothered by women who rely on society to support them, and not because they are scared and/or confused, but come into our hospital with an attitude! They bring all of their friends and clean out our refridgerator so that now our patients who delivered have NO food, are disrespectful to us, steal from our patients and us, and then leave AMA only to return again. They come in with PTL after using coke, seeking care I assume, and then refuse care when we try to stop her labor. Then she delivers in the street, ends right back up in our unit with a sick baby who's in the NICU for months. We are paying for that!

These women aren't having children because they love children. They are having sex for the simple fact of having an orgasm. My patients don't want condoms because it doesn't feel as good, and they like the feeling of the man ejaculating inside them. They don't like Depo because it is a shot and they are "afraid of needles" yet they are covered in tatoos and shoot up heroein. They "forget" to take the pill. If they "forget" to take a pill, or "forget" to see thier OB, how are they going to care for their 6 children? Will they forget to feed them, give them thier medicine?

These same women who come in and we give them everything from formula, diapers, car-seats, MD visits with our residency program, free birth control - also come in with cell phones and gold jewelry - designer clothes and shoes. I don't even have a cell phone and I have only my wedding ring!

I once did post-partum home visits in inner-city Milwaukee - these small apartments had children running all over, unclothed, dirty etc. But inside their apartments were better stereos, DVDs, 60 inch TVs, etc than I ever owned. I can't afford that, how can they? These women go into the stores with food stamps and either sell them for booze, neglecting thier hungry children, or buy food for themselves like a bag of Doritos and soda. These women are smart. They know what they have to buy, they just refuse to. They refuse to go to their WIC classes on nutrition, they refuse to go to interview/resume building classes, MD visits, etc. To have more children is a disgrace! Why should someone be allowed to continually make mistakes, and not just on themselves, but mistakes that affect lives? To me that is the greatest injustice and form of abuse I can ever imagine.

If these women knew that if they got pregnant one more time, they would have to have a tubal, you know they would be more careful. We wouldn't see them again. Somehow, they would get over their fear of needles (except with tatoos, piercings and drugs) and they certainly would remember to take a pill. The women I see and the women I am talking about are not the indigent ones you are describing. The women I see are smart enough to abuse the system, and use their desire for self-gratification and their own children to help them.

Specializes in LDRP; Education.
Originally posted by kday:

The only true 'VICTIMS OF CIRCUMSTANCE' are the babies lying up in NICU thanks to their drug-using mothers, the dead children BEAT TO DEATH by their mother's abusive boyfriend or father's abusive girlfriend, the toddlers and school age children who die in house fires while their irresponsible parents leave them unattended so they can go 'party,' and kids like the two 11 year olds we had in labor one time who were pregnant because they were RAPED by an uncle. The innocent ones are the KIDS, people, and by letting the irresponsible adults in their lives believe they aren't responsible for their actions and not making them suffer consequences, the KIDS are the ones who get screwed. The kids don't HAVE a choice. Their parents DO.

Beautifully stated, Kday.

Specializes in LDRP; Education.

I also just want to clarify - I'm not some butcher. I say "mandatory" sterilization because when I see these women (like the gravida 21) that's when I think something like a tubal should be done. Tubals are also reversible.

I guess it's more what I'd like to see happen. I know there's all sorts of other issues with having mandatory tubals; we'd be getting into a slippery slope with that - but it's just frustrating and that's the first thing I think of.

Brownie,

Spoken like a true liberal Democrat. You need to come to Guam and see how the true abuse of the welfare system works. We always focus on the poor unfortunates who can't survive without welfare. Why don't we look for the ones who did make it off welfare and educate themselves. Find out how they did it. Just to continue to throw free money at the situation is not the answer.

I really think the big point here is that it is the infant who is getting punished for the stupidity of adult actions.

Specializes in Everything except surgery.

I want to thank those you who still have a heart, and haven't been hardened by effects of the serious problems we ALL see each day. Yes, I do think this board should be a place to vent frustrations, but I was just taken back by some of things I read. I guess because this is a subject, that I have strong feelings on.

I don't however feel that the response my post received from kday, was warranted. I wish to ask you, who are you referring to as "YOU"??? I would also like to know, on who's bootstraps did these lucky individuals pull themselves out of adversity with? Did they just one day wake up, and just do the right thing, or did someone help them to see a better way. It's strange how in one family alone, you can have 1 or more who didn't get the message they could succeed, or just can't seem to make it out on their own. You see it everyday...every person has their own needs, and abilities, and must be approached in what stimulates them, not anyone else! I sincerely hope, you don't have to make the same choices some women have to make, who feel that any real choices were taken away from them by abusive parents, and or husbands. If you haven't walked in a person's shoes, how you can even start to judge what their choices are, or aren't?

I'm saying, don't be so easy to crititize those who haven't woke up yet! I have a problem with perm, solutions being made for some else. Generalization aren't right in any situation.

I don't believe depo is the solution, just as abortion isn't either. Abortions is the reason some who can't have children now. Too many easy way outs, while they too, were doing drugs,and used that as their justification for having late term abortions. I feel this is an atrocity, that should never be allowed to happen. Why don't these women make the choice they need to, before some of them are in their last trimester? The same reason, drug mothers make the decisions they do. Inability to face the problems they're dealing with, and feelings of depression, that keep them from acting sooner.

The women who aren't on welfare, who have children with men, and know they can't support them. Then kick them to the street, so others can care for them. What should their punishment be? What would make them to this to their own children?

We also must bring in the fact that many minority women, don't give their children up for adoption, because of family, and community pressure. I think many women would be willing to give their children to better homes, if the possiblity was available to them.

But I ask again...Where are you going to send these children you take away?? Are you willing to take these children into your homes?? What institition should they go to, and are you going to support them until they're productive human beings? Or should we help their mothers do this?

My opinion as to how to be supportive, but firm in helping women stop the cycle.

I think that as soon as a woman signs up for benefits, she should also sign up for parenting classes, a job training program, and a support group. In order to continue benefits she must complete a program to get her GED, and if she is in an abusive situation, have housing provided to keep her safe. While there she would received counseling on making the best responsible decision possible for herself, and her baby.

Before delivering, she must have accepted a job, that would start within 3months of delivering, and start working Part time, while continuing to participate in training, and support group, with ongoing consuling. When she has completed training, and worked into a full time position, benefits would be deminished. She would stay in the support group, and be monitored, for 5yrs, or until she will preforming on her own, with no relaspes.

She must have the father brought in for testing, and adjudicated as the father, who is made to help provide child support, or face penalties, and arrest. He also must receive the same training, the mother does, and be made to obtain a job, and or to pay the state back for any costs incured for the birth of this child, and pay child support. If he is a drug abuser, he should complete a drug treatment program, and submit to weekly or monthly drug treatments. If he fails to do this,, ie. he comes up positive, or fails to follow the program, he will immediately be placed on home detention, until he is neg for drugs, and or decides to follow the program. The woman must also submit to random drug screens, and the same punishment.

This would not only help them see a better way, but make the thought of having another child a little less likely. Now if this is her second pregnancy, and she tests pos for drugs, she would immediately be sent of detention, as soon as she tests positive. She would be required to care for her child in the facility, and complete a drug program, have a job before she leaves detention. If the same man has inpregnated her again, he will also be placed in detention, and made to pay for all expenses of this women, and the child.

I feel the system needs to get serious on the first pregnancy, not the 21st! If you allow anyone to continue to run wild without consequences, you run the risk of never getting them to see any problem with their behavior. But you can't assume they were taught the same life judgements they need to make good choices. You have to have something to start with, to make a good decision. Everyone going through a change, needs a support group, except for those who are totally self-sufficient, and need no ones help doing anything. To those people, I say more power to you, but give the rest of us a freaking break...please!

Again,...what are some of you doing to stop these horrors that affect you so strongly? Life is full of "choices", and many, make the wrong ones! Just look at the divorce statistics. I mean, this country is making bad choices at an accelerating rate everyday.

And plenty of children are getting hurt, with each bang of the gravel. Just because their parents made bad decisions, or men/women decide they no longer want to be responsible....Maybe we need to have a committee decide who should have children, and who shouldn't. Isn't that a scary thought.

As for those who feel that because they pay a few dollars for welfare, they should be able to say how these people rights are determined. I wonder if this is what employers feel, when they pay their hard earned money out. Wonder if this is why they feel, they should be able to control our lives, to threaten us with losing our licenses, make us stay for madatory OT, harrass us at home during our off times! Just wondering!

The Boss, your post made me cry, as soon as I read it. I have seen the same thing you have described, and it saddened me it still continues.

Susy K...why do you think these women continue to do this?? I mean, they aren't getting rich on welfare, as many would like to think. Do you really think all welfare women live like this? Do you really think this kind of mentality is only seen in welfare women?? There are professional women right now, who don't have their children, and would probably suppass the number of children with the number of late term abortions, they have had! Have you ever seen one of these?? Have any other these programs addressed the root of the problems, not the SXs only? It's like trying to patch up the holes of a dam with only few plugs, that really needs some new concrete.

I have presented my view on this discussion, and I haven't attacked anyone in the process. I have only expressed my opinion.

I didn't label anyone for any opinion they expressed. Also Navy, I'm NOT a liberal Democrat, I'm independent! But I did vote for Gore, as I abhored him less than I did Bush! And thanks for the invite, but I have been to Guam already! I never said welfare was a solution to anything. I just believe there should be more of a commitment to help women/men become better people, and in the process better parents. The cycle has to be stopped somewhere, but sterilizing people isn't the way to solve the program in my opinion! I didn't become a welfare mother, but I wouldn't for a moment think that I'm immune, or better in anyway. I just figure I was a little luckier than some! Thank God for His Grace!

Brownie

Hi, Brownie!

I am in total agreement with your viewpoints and your obvious compassion. I am one of those registered "bleeding heart" Liberals. But, I do not believe the government should control our bodies as they do in China and elsewhere.

I have a cousin who is mildly "mentally retarded". She was sterilized as a teenager to prevent further "deficient" children. The cause of her impairment was due to anoxia at birth. She is married, employed, and is wonderful with children. She'd give anything to be a Mom - of course - adopting is not an alternative for a woman in her situation. The government took away her right to conceive as they once did to many women. Certainly, would not want to see this country revert back to the dark ages.

During my employment with an OB/GYN practice I saw such contempt from every Nurse I worked with when faced with a pregnant teenager. How could this attitude possibly help these girls? I began intercepting all the prenant teens because my heart couldn't deal with the coldness. I imparted whatever knowledge I could provide during their pregnancy and postpartum care and encouraged their boyfriends to attend all prenatal visits. Education, I believe, is the answer.

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